Provider Demographics
NPI:1427930221
Name:ADEGOKE, JULIUS ADEYINKA OLUWATUNAYO SR
Entity type:Individual
Prefix:
First Name:JULIUS
Middle Name:ADEYINKA OLUWATUNAYO
Last Name:ADEGOKE
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 TENNESSEE ST APT 18
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-4457
Mailing Address - Country:US
Mailing Address - Phone:951-577-4963
Mailing Address - Fax:
Practice Address - Street 1:100 TENNESSEE ST APT 18
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-4457
Practice Address - Country:US
Practice Address - Phone:951-577-4963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA01334024376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty